From Invisible Symptoms to a Coordinated Care Pathway – Region Dalarna’s Digital Menopause Clinic

Although menopause affects most women, many find it very difficult to get the right support and help from the healthcare system. A lack of understanding and knowledge about the symptoms, long wait times, and a feeling of not being taken seriously are recurring complaints from women in the media and in online forums.

Region Dalarna in Sweden wanted to do something about this, which has been a lifeline for many women. Since 2025, the region has offered a county-wide digital menopause clinic for menopause-related symptoms. After just one year, the clinic is seeing high demand, high patient ratings, and a need that has quickly exceeded expectations.

For many women, the clinic has become a new and valued gateway to healthcare—and an example of how digital healthcare models can make specialized expertise more accessible, regardless of where the patient lives.

“We see the woman”

The menopause clinic is based in the city of Avesta but serves women from all over Dalarna. Appointments take place digitally via 1177 Direkt (a digital care service that lets you seek medical help online) and are led by midwives with specialized knowledge and an interest in menopause-related issues. Doctors are available at the clinic several times a week when medical assessment or additional interventions are needed.

For Carola Olsson, coordinator of the menopause clinic, the clinic’s mission is largely about listening.

“We listen to the woman as she describes her problems and symptoms. And we see the woman.”

That’s an important point. For many women, menopausal symptoms aren’t about a single symptom, but rather a cumulative impact on sleep, mood, energy levels, relationships, work capacity, and quality of life. When healthcare only treats the symptoms individually, there’s a risk of missing the underlying cause.

Carola Olsson describes how women sometimes receive help for sleep problems, pain, or low mood but not for menopausal symptoms as a whole.

“In such cases, they aren’t treated for menopausal symptoms, but for the individual symptoms. If the symptom is that you can’t sleep, ‘take a sleeping pill.’ If the symptom is that your whole body aches, ‘take a painkiller.’ But you’ve actually entered menopause.”

A digital clinic that lowers the barrier to care

Making the clinic digital was a natural choice, since its mission covers the entire Dalarna region. Patients can seek care digitally, and healthcare professionals – such as those in primary care – can refer them directly to the menopause clinic.

This means that women can access counseling, assessment, and, in some cases, medical treatment without first having to navigate between different clinics and wait for an in-person appointment.

This is particularly important for patients in rural areas or in communities where access to specialized expertise is limited. The digital model makes it possible to offer more equitable care across the entire region, with the same level of expertise and approach regardless of where patients live.

Since the clinic opened about a year and a half ago, around 2,000 visits have been conducted. Demand continues to rise at a pace that the clinic is struggling to keep up with.

“Help is available, but it may take a little time. I don’t think many people are disappointed in any way; the only thing they’re dissatisfied with is that they can’t get an appointment sooner. But we’re doing everything we can,” says Carola Olsson.

The right expertise at the right stage

An important part of the clinic’s approach is that midwives and doctors can collaborate within a clear digital care pathway. The midwives meet with patients, provide counseling, and conduct follow-ups. When necessary, doctors are brought in for medical evaluation, testing, or treatment.

This creates a structure where patients receive help from the right expertise at the right stage, while primary care resources are used more efficiently.

The digital approach can also relieve pressure on in-person clinics. When women experiencing menopausal symptoms can receive support through a specialized digital clinic, it frees up time in primary care, while patients receive more coordinated and knowledge-based care.

An area where healthcare needs to improve

The need for improved menopause care is not just evident in patient demand. The National Board of Health and Welfare has highlighted in national guidelines that there is a lack of knowledge about menopause within primary care and that women with menopausal symptoms are not always treated in the desired manner.

This is something Carola Olsson recognizes from the women she meets.

“I spoke with a woman just today who told me she was so disappointed with how a doctor treated her that she decided to switch health centers. That’s the most important takeaway from the National Board of Health and Welfare’s guidelines: to improve how patients are treated and strengthen expertise.”

Digital care is more than just a way to increase accessibility. It also offers an opportunity to pool expertise, build experience, and create more consistent practices throughout the region.

Follow-up, continuity, and quality of life

To handle the high volume of requests, the clinic begins with a digital group information session, followed by an individual digital visit to the menopause clinic if needed. During the visit, which lasts about an hour, the woman is given the opportunity to describe her symptoms, her situation, and how the symptoms affect her daily life. Sometimes medical treatment is needed; other times, lifestyle advice and support are sufficient. The clinic also conducts follow-ups after three months of menopausal hormone therapy (MHT) and, after one year, performs a final risk-benefit assessment.

This follow-up is important. Menopausal symptoms can change over time, and treatment often needs to be tailored to the individual’s needs. Through digital follow-ups, women can receive ongoing support without having to start over in the care pathway.

This creates better conditions for continuity, security, and personalized care.

“It usually goes really well,” says Carola Olsson.

A model for more patient groups?

Region Dalarna’s menopause clinic demonstrates how digital care can be used to build more accessible and cohesive care structures for patient groups that would otherwise risk falling through the cracks.

The initiative is not intended to replace necessary in-person care. Instead, it’s about using digital approaches where they are most beneficial: to lower barriers to care, pool expertise, relieve the burden on primary care, and provide patients with a faster path to the right support.

For women experiencing menopausal symptoms, this can mean the difference between continuing to seek help for individual symptoms and actually having their entire situation recognized.

Perhaps this is precisely where the true potential of digitalization lies: not in creating yet another gateway to healthcare or yet another system, but in making healthcare more accessible, equitable, and tailored to patients’ actual needs and circumstances.